Lantus increase not helping

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Julia78

Julia78

Member Since 2020
I hope everyone is well. Pepper has been on his new dose of Lantus for over a month now and his numbers don't seem to be improving. Do you think I should increase his dose?
 
Julia78 said:
I hope everyone is well. Pepper has been on his new dose of Lantus for over a month now and his numbers don't seem to be improving. Do you think I should increase his dose?
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I replied on the other thread. YES

do not hold a dose for longer than a week. What protocol are you following? I assume SLGS because with TR you’d be increasing much faster
 
Julia78 said:
Thank you. I'll start tonight. Do you know what my goal numbers should be?
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We adjust the dose by the nadir, lowest point in a cycle. You need to pick a protocol so you can follow its guidelines for dosing. Generally speaking, the ideal nadir range is 60-120 in a human meter. You want your cat to be under 200 most of the time. You want to start seeing blues and green in your ss
 
Wow yes, Pepper has been on the same amount for a long time. It's rare for a kitty to stay on the same dose for more than a week. If nadir (lowest point in the cycle, when BG is at its lowest) is consistently above 150 after 7 days, increase by 0.25 units. If using Tight Regulation protocol, you increase after 3 days instead of 7.
 
Panic said:
Wow yes, Pepper has been on the same amount for a long time. It's rare for a kitty to stay on the same dose for more than a week. If nadir (lowest point in the cycle, when BG is at its lowest) is consistently above 150 after 7 days, increase by 0.25 units. If using Tight Regulation protocol, you increase after 3 days instead of 7.
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I feel terrible. Thanks for your input.
 
Don't feel bad at all, there are so many "rules" to managing diabetes you often learn by trial and error. I did the same thing! Luckily Pepper is still in very low 300s so I think you'll have an easier time of it than if she was in 400-500s. We increase frequently because their needs are frequently changing... the longer they stay too low the higher likelihood for glucose toxicity to set in, which is sort of like a barrier, making insulin ineffective until you increase (sometimes multiple times) until you "break" through.
 
Julia78 said:
Both protocols seem confusing. I have to read them again after I get some sleep. Thanks to all.
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They're not, promise. :) Maybe some shut-eye will help. The (very summarized) basis for both is:

SLGS: Reductions under 90, increase after 7 days
TR: Reductions under 50, increase after 3 days

And TR requires at least 4 tests a day - that's both pre-shots and one mid-cycle test every cycle. And no dry food. No issue for you.

Get some rest!
 
Panic said:
They're not, promise. :) Maybe some shut-eye will help. The (very summarized) basis for both is:

SLGS: Reductions under 90, increase after 7 days
TR: Reductions under 50, increase after 3 days

And TR requires at least 4 tests a day - that's both pre-shots and one mid-cycle test every cycle. And no dry food. No issue for you.

Get some rest!
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Please give me your address so I can send you three dozen roses of appreciation!
 
Julia78 said:
Do most people here use TR?
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Probably, if I were to guess? SLGS is ideal for people who can't test often, but TR is an actual published protocol. TR is more aggressive in that it keeps the cat in better numbers and doesn't really give the body a chance to stay too long in higher numbers, which gives their pancreas the ability to stay in "healing numbers" longer, ultimately helping to achieve remission sooner. Nothing wrong with either one, just kinda depends on your lifestyle!
 
Julia78 said:
I work 8 hours a day, so it might be impossible for me to implement TR.
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Not impossible! Here is a sticky all about doing TR on a full time schedule. :)

HOWEVER, I'm not trying to push you into having to do TR, just showing that it is definitely possible. I do actually prefer to encourage people to start with SLGS and wait until they feel "ready" to graduate to TR. There's nothing saying you have to choose one and no backsies. You can change your mind.
 
Panic said:
Not impossible! Here is a sticky all about doing TR on a full time schedule. :)

HOWEVER, I'm not trying to push you into having to do TR, just showing that it is definitely possible. I do actually prefer to encourage people to start with SLGS and wait until they feel "ready" to graduate to TR. There's nothing saying you have to choose one and no backsies. You can change your mind.
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You’ve been so helpful. Thank you so much.m
 
Julia --

You may want to consider posting on the Lantus board. Here on Health is a great place to get started and learn how the Board works. As you're getting more experienced, you may find it helpful to move to the insulin-specific board. Many of the same people post there but there are also a lot of people using Lantus who can offer guidance and support.
 
Sienne and Gabby (GA) said:
Julia --

You may want to consider posting on the Lantus board. Here on Health is a great place to get started and learn how the Board works. As you're getting more experienced, you may find it helpful to move to the insulin-specific board. Many of the same people post there but there are also a lot of people using Lantus who can offer guidance and support.
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Sienne and Gabby (GA) said:
Julia --

You may want to consider posting on the Lantus board. Here on Health is a great place to get started and learn how the Board works. As you're getting more experienced, you may find it helpful to move to the insulin-specific board. Many of the same people post there but there are also a lot of people using Lantus who can offer guidance and support.
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Thank you, I will check it out. : )
 
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